Musculoskeletal screening: Implications for injury and performance


Student thesis: Doctoral Thesis


Reducing injury is a challenge for Sports Medicine professionals due to the significant physical, psychological and financial implications of injury. General injury prevention models highlight the need to identify injury risk factors and based on this premise four themes were developed which focused on screening tools. In theme 1, joint hypermobility prevalence and the different methodological assessment tools were investigated within sport and dance populations. Joint hypermobility prevalence was greatest in dancers and lumbar flexion was identified as a performance adaptation in this cohort. Gender and the activity performed were important considerations and the joint hypermobility methodological assessment tools must be considered. Arthralgia and dislocation/subluxation were most prevalent in dancers and the BS was a predictor of arthralgia and dislocation/subluxation. In theme 2, a systematic review and meta-analysis of the role of musculoskeletal screening as a predictor of injury in dance revealed that there is a need for prospective injury design and that turnout measures may predict dance injury. The Functional Movement Screen and Star Excursion Balance Test were investigated in relation to injury and performance in rugby and netball. A Functional Movement Screen composite score of 11.5 was identified to provide the best sensitivity and specificity scores for identifying potential injury in male and female rugby players. The hurdle step, active straight leg raise, and deep squat and anterior reach were identified as the best predictors of agility. In theme 3, mechanical loading demands and the relationship between musculoskeletal screening and performance were investigated in dancers. Accelerometry placement was highlighted as an important consideration and the deep squat was identified as the primary predictor of dance performance while the movements of the Star Excursion Balance Test had limited predicative value. Hypermobility was found not to relate to mechanical loading. In theme 4, the relationship between fatigue and screening was investigated in dancers and Star Excursion Balance performance was not influenced by fatigue. The in-line lunge, hurdle step and deep squat elements of the Functional Movement Screen demonstrated a significant reduction in performance levels highlighting a possible area for intervention. These studies provide an original contribution to knowledge by comparing hypermobility prevalence across a number of different sports and dance which have not previously been investigated and provide direct comparison with consideration of varying degrees of hypermobility and the importance of categorisation. The systematic review and meta-analysis is the first such review in dance screening and contributes some important considerations for practitioners working with dancers. The two studies that investigated the Star Excursion Balance Test and Functional Movement Screen and their potential role in agility prediction and identification of injury highlight some important considerations for the management of agility training and injury prevention. The five studies that utilised the Dance Aerobic Fitness Test protocol provide important findings regarding performance prediction, accelerometer placement and fatigue effects in relation to injury. It is anticipated that these studies may aid the development of effective screening protocols.
Date of Award3 Jun 2019
Original languageEnglish
Awarding Institution
  • Edge Hill University


  • Fatigue
  • Injury
  • Joint Hypermobility
  • Performance
  • Musculoskeletal Screening

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